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Click ‘Get Form’ to open the lic 701 in the editor.
Begin with Part A, where a parent or guardian must provide consent. Fill in the child's name and birth date, followed by the name of the child care center and its operating hours.
In Part A, ensure that the parent or guardian signs and dates the form to authorize the release of medical information.
Proceed to Part B for the physician's report. The physician should complete this section by noting any health concerns such as allergies, vision issues, and developmental considerations.
Fill out the immunization history section accurately, detailing each vaccine received along with corresponding dates.
Lastly, review any TB risk factors present and have the physician sign and date at the bottom of Part B.
Start filling out your lic 701 form online for free today!
As a Child Care Licensing Specialist, you will serve our community by assessing, licensing and monitoring childcare providers and childcare centers for compliance with childcare licensing regulations set forth by KDHE and support the fulfillment of the organizations mission and values.
How much does it cost to get your daycare license in California?
Every licensee must also pay a yearly licensing fee. A small family childcare homes annual licensing fee is $73. A large family childcare homes annual licensing fee is $140. A childcare centers annual licensing fee is equal to one-half of the application fee.
What is an example of a type of violation of child care licensing?
Type A:This is the most serious type of violation that means there is an immediate risk to the health, safety or personal rights of those in care. Examples: lack of supervision, lack of fire clearance and access to dangerous chemicals.
What is lic 701?
Physicians Report - Child Care Centers California: LIC 701 form. Form Template. This Child Care Center Physicians Report is designed for both parents and health care professionals to provide important health information for children being enrolled in a child care facility center in California.
Consult with your local health departments TB control program on any aspects of TB prevention and treatment. LIC 701 (8/08) (Confidential). PAGE 2 of 2.
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